Provider Demographics
NPI:1881017564
Name:MARRIOTT, RACHEL (LM, CPM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MARRIOTT
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 APRICOT RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2317
Mailing Address - Country:US
Mailing Address - Phone:805-587-1957
Mailing Address - Fax:805-521-3646
Practice Address - Street 1:4380 APRICOT RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2317
Practice Address - Country:US
Practice Address - Phone:805-587-1957
Practice Address - Fax:805-521-3646
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 382176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife